The octahedron has a much higher angular defect (https://en.wikipedia.org/wiki/Angular_defect) than the dodecahedron, and thus when it is projected onto the sphere the cells are warped a lot. So while their areas may be the same, the shapes vary.
Not sure I understand—healpix starts from the rhombic dodecahedron and then bisects the generalizations of the 12 squares each time. Where do octahedra come into play?